Latest Round of Health Reform Benefits Kicks In

Backlash Also Notches Up, With Some Insurers Deciding to Drop Child-Only Policies

Health Reform Highlights continued...

Existing health plans can avoid some of these changes by seeking ‘’grandfathered’’ status. But to achieve that designation, these plans can’t make significant changes to benefits or raise consumers’ costs substantially.

A survey by consulting firm Mercer released this month found that 53% of employers believe they are likely to keep grandfathered status for all their plans. Employers also estimated that health care reform requirements would add 2.3%, on average, to the cost of their health benefits next year.

Already launched under reform are “high-risk” pools in states for people with pre-existing medical conditions who have been denied coverage. Enrollment has been slow, but DeParle said this week that “several thousand” people are now covered in these pools.

Uninsured Americans

The uninsured problem, though, continues to grow as the high unemployment rate persists. A newly released Census Bureau report found the number of Americans without health insurance climbed sharply in 2009 to its highest level -- 50.7 million.

A central goal of health care reform is to cover millions more Americans. And in 2014, when reform is fully implemented, individuals would be required to have coverage or face a penalty. Another key change for 2014: Insurers won’t be able to charge more for people with pre-existing medical conditions.

A related reform provision kicking in this week -- that health plans accept children with pre-existing conditions -- has hit a snag. Some major health insurers have decided to stop offering new child-only health policies, which often are purchased by unemployed parents or those who don’t have dependent coverage in their health plans.

The Denver Post reported that at least six major insurers -- including Aetna, Anthem, Cigna, and Humana -- have said they would stop writing new policies for individual children, citing health reform mandates.

An industry trade group, America’s Health Insurance Plans, said that insurers would accept children with pre-existing conditions in other plans. But a spokesman, Robert Zirkelbach, also told The Washington Post that including that coverage in child-only plans ‘’provides a very powerful incentive for a parent to wait until their child becomes very sick before purchasing coverage.’’